Two old drugs combine for new effect

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University of Chicago researchers presented preliminary research demonstrating that Qsymia, a diet drug that is a combination of phentermine and topiramate, can successfully reduce both body weight and blood pressure. Obese or overweight individuals who used the drug over 56 weeks lost more than ten percent of their body weight, and those participants also saw their blood pressure drop by 11 to 12 mm mercury for systolic and 7 to 8 mm mercury for diastolic.

The intriguing part of the story is that neither of these drugs is new. Phentermine, an amphetamine, has been used for decades for weight loss. It was considered a safe drug until, in the 1990s, it was combined with dexfenfluramine in the infamous Fen-Phen weight loss drug, and this combination increased the risk of serious cardiovascular conditions.

Topiramate, also a widely used drug, is an anti-seizure medication, long-used for some forms of epilepsy. Qsymia, although it can raise heart rate slightly, doesn t otherwise seem to have the type of negative cardiovascular impact attributed to Fen-Phen. Indeed, one significant benefit of the drug is the reduction in CVD risk factors that come from weight loss.

Dr. George Bakris, lead author on the study, was quoted in Med Page Today saying, Of the weight loss drugs that are available, it s safe and well-tolerated, certainly at low doses. It s not associated with cardiovascular risk.

Qsymia, however, is not for everyone. The manufacturer s website warns that the drug can cause certain birth defects cleft palate and cleft lip and thus should not be taken by women who are or may become pregnant. Because of this possibility, use of the drug requires a Risk Evaluation and Mitigation Strategy (REMS) of repeated pregnancy testing and effective contraceptive use by women who are potential candidates for Qysmia use.

Dr. Bloom comments We really need some new pharmaceutical aids in our weight loss armamentarium. Once Fen-Phen was withdrawn in 1997 there was not a single effective weight loss drug. Coupled with the large population that needs pharmaceutical intervention to aid in weight loss, Qsymia becomes a very important drug.

We hope that continued surveillance of this product will confirm the safety and efficacy results presented at this conference.